Kang Chang Moo, Lee Jung Woo
Department of Surgery, Yonsei University, College of Medicine, Seoul, Korea.
Hepatogastroenterology. 2009 Jul-Aug;56(93):1207-10.
Laparoscopic distal pancreatectomy is suitable for benign and premalignant neoplasms located in the body and tail of the pancreas. In addition, spleen-preservation following distal pancreatectomy for benign or low-grade malignant disease is known to be safe. We present a case of 32-year-old female patient with a solid pseudopapillary tumor of the pancreas treated by spleen-preserving laparoscopic distal pancreatectomy with segmental resection of the splenic artery and splenic vein intact. She had uneventful postoperative recovery and was discharged on the 6th postoperative day. Follow up Doppler-ultrasound scan showed no evidence of splenic infarction and well-preserved splenic blood flow.
The surgical strategy of segmental resection of the splenic artery with intact splenic vein for spleen preservation seems feasible and represents an alternative option for spleen preservation in laparoscopic distal pancreatectomy. More clinical experience is required to address the advantages, limitations, and reproducibility of this technique.
腹腔镜远端胰腺切除术适用于位于胰体和胰尾的良性及癌前肿瘤。此外，已知对于良性或低度恶性疾病行远端胰腺切除术后保留脾脏是安全的。我们报告一例32岁女性患者，患有胰腺实性假乳头状瘤，接受了保留脾脏的腹腔镜远端胰腺切除术，脾动脉和脾静脉节段性切除，脾动静脉完整。她术后恢复顺利，术后第6天出院。随访的多普勒超声扫描显示无脾梗死迹象，脾血流保存良好。
脾静脉完整的脾动脉节段性切除以保留脾脏的手术策略似乎可行，是腹腔镜远端胰腺切除术中保留脾脏的一种替代选择。需要更多临床经验来阐明该技术的优势、局限性和可重复性。
